ABSTRACT
Historically, the treatment for persons with Chronic Obstructive Pulmonary Disease has been directed toward the remission or stabilization of the acute complications that frequently hospitalize them, or motivate them to seek medical attention. Therapy has focused on treatment of these exacerbations with medications and rest. In 1984, a small multidisciplinary group at Duke began to identify the need for an ongoing form of education and therapy for pulmonary patients once they were discharged from the hospital. With the advent of Diagnosis Related Groups, many physicians and therapists were frustrated by the lack of time available to rehabilitate pulmonary patients adequately in the hospital setting. The initial patient evaluation includes a symptom limited maximum cycle ergometer exercise test combined with metabolic gas and arterial blood gas analysis, electrocardiogram, and blood pressure monitoring. Static and dynamic pulmonary function tests and a chest x-ray are also obtained prior to entrance into the program.
